Detection And Significance Of The Alteration Of Th17Cells In Patients With Hashimoto’s Thyroiditis And Graves’ Disease

Backgroud：Autoimmune thyroid disease （AITD） is one of common human organ-specific autoim-mune diseases.In recent years, the incidence of this disease have a tendency to increase.It hasbecome a common disease in the Department of Endocrinology.AITD, including autoimm-une thyroiditis （AIT）, Graves ’disease and Graves’ ophthalmopathy.AIT is a major cause ofadult hypothyroidism.It includes four types:Hashimoto’s thyroiditis （HT）, atrophic thyroiditis（AT）, painless thyroiditis, postpartum thyroiditis （PPT）,with Hashimoto’s thyroiditis is themost common.The pathogenesis of AITD is not only with the genetic and environmentalfactors, and a closer relationship with thyroid autoimmunity.But its pathogenesis is not yetcomplete explanation.CD⁴⁺ T cells play a central role in the immune defense.In recentyears, scholars have discovered a new type of CD⁴⁺ T cells different from Th1, Th2and Trcells,which can specifically produce high levels of interleukin17（IL-17）, known as Th17cells, it is characterized by the secretion of cytokines IL-17, may be involved in a variety ofautoimmune diseases incidence link, has become the hotspot of immunology and relatedfields.Objective：1.Explore the Th17cell levels and thyroid autoantibodies levels in peripheral blood ofthe patients with autoimmune thyroid disease （Hashimoto’s thyroiditis and Graves’ disease）.2.Explore the Th17cell levels and thyroid autoantibodies levels in peripheral blood ofboth the patients with Graves ’disease after applied the Methimazole treatment. and thepatients with Hypothyroidism and Hashimoto’s thyroiditis after applied the levothyroxinetablets.Methods：1.Collecting30cases of patients with Hashimoto’s thyroiditis （HT） and Graves’ diseaseRespectively. Collecting healthy control group of20cases.Explore the Th17cells in CD⁴⁺T cell percentage in peripheral blood of all groups of subjects by application ofintracellular cytokine staining by flow cytometry assay.Detecting each group thyroglobulinantibodies （Tg-Ab）, thyroid peroxidase antibody （TPO-Ab） and thyroid-stimulating hormonereceptor antibody （TRAb） levels by the method of Electrochemiluminescence immunoassay. 2.Collecting20cases of patients with Graves disease, with the application ofThiamazole treatment for8weeks.Collecting20cases of hypothyroidism in patients withHashimoto’s thyroiditis, with the application of levothyroxine tablets in the treatment of8weeks.Detecting the Th17cell levels and thyroid autoantibody levels in the peripheral bloodof each group.Results：1.The peripheral blood Th17/CD⁴⁺ T cell percentage of patients with Hashimoto’sthyroiditis and Graves’ disease are respectively （3.05±1.17）%、（3.94±1.46）%, were higherthan the normal control group:（2.42±0.82）%,there was significant difference（P<0.05ï¼›P<0.01）. Elevated in patients with Hashimoto’s thyroiditis is more obvious.2. The levels of TPO-Ab,Tg-Ab, TRAb in patients with Hashimoto’s thyroiditis arerespectively （342.60±237.25）IU/ml、（1146.30±1126.33）IU/ml、（4.11±9.19）IU/L, TheTh17/CD⁴⁺ T cell percentage was a significant positive correlation with TgAb in peripheralblood of patients with Hashimoto’s thyroiditis（r=0.737，P<0.01）, AlphaTPO-Ab, TRAb was no significant correlation（r=-0.107，P=0.654ï¼›r=-0.039，P=0.87）.Hypothyroidism in patients with Hashimoto’s thyroiditis, before and after the treatment ofshort-term application of levothyroxine tablets,Th17/CD⁴⁺ T cell percentage and the levelsof TPO-Ab,Tg-Ab and TRAb are no significant changes（Both P>0.05）.3. The levels of TPO-Ab,Tg-Ab, TRAb in patients with Graves’ disease are respectively（143.52±177.37）IU/ml、（270.56±272.34）IU/ml、（12.83±12.0）IU/L, The Th17/CD⁴⁺ T cellpercentage was no obvious correlation with TPOAb,TgAb and TRAb level in patients withGraves’ disease（r=0.056，P=0.816ï¼›r=0.001，P=0.997ï¼›r=-0.234，P=0.321）. Patients withGraves’ disease,before and after the treatment of short-term application of Methimazole,Th17/CD⁴⁺ T cell percentage and the levels of TPO-Ab,Tg-Ab and TRAb are no significantchanges（Both P>0.05）.Conclusions：1.The peripheral blood Th17/CD⁴⁺ T cell percentage in the Patients with autoimmunethyroid disease （Hashimoto’s thyroiditis and Graves’ disease） is higher than Normal controlgroup. Elevation in patients with Hashimoto’s thyroiditis is more obvious.Detection ofTh17/CD⁴⁺ T cells can be considered as one of the basis for the diagnosis of autoimmunethyroid disease.Significance of the diagnosis of Hashimoto’s thyroiditis is more meaningful. 2. Th17/CD⁴⁺ Tcell percentage and Tg-Ab was a significant positive correlation inHashimoto’s thyroiditis patients, and TPO-Ab was no significant correlation. The treatmentof short-term application of levothyroxine tablets in Hypothyroidism in patients withHashimoto’s thyroiditis can not change the level of peripheral blood Th17cells and thyroidautoantibodies levels.3.Th17/CD⁴⁺ T cell percentage was no significant correlation between thyroidautoantibodies in patients with Graves’ disease. The treatment of short-term application ofMethimazole in patients with Graves’ disease can not change the level of peripheral bloodTh17cells and thyroid autoantibodies levels.